[Question #7942] PEP question
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50 months ago
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Dr.HHH,
I have a question about PEP and will appreciate your input. Now a days the recommended PEP regimen typically includes Truvada once daily
in addition to one other med such as Tivicay. However, in the past, many doctors
and clinics only prescribed Truvada once daily as PEP. Has something changed in recent years? Has any
study or evidence came out in the past few years indicating that Truvada needs
to be taken with another med in order to be an effective PEP therapy? Thank you for your help.
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H. Hunter Handsfield, MD
50 months ago
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Welcome back, but sorry you found it necessary.
You're describeing the difference between standard pre-exposure prophylaxis (PrEP) and PrEP "on demand", which has been recommended more recently. Nothing has changed except that research on PrEP on demand has been done and it was found to be very effective -- equally effective as ongoing PrEP. Both are preferred over post-exposure prophylaxis, or PEP.
In other words, there are three kinds of drug treatment to prevent HIV: 1) Standard PrEP, taking drug continuously, the best choice for someone with relatively frequent risky exposure. 2) PrEP on demand, the simplest method (only 3 doses of drug), equally effective as standard PrEP, and most suitable for people like you, with only occasional risky exposure. 3) Post exposure prophylaxis (PEP), i.e. taking treatment after a risky event. It is the least effective for HIV prevention and least convenient.
Truvada alone is effective for all of these; no other anti-HIV drug is necessary.
HHH, MD
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49 months ago
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Thank you for your respone Dr.HHH. You mentioned that PrEP on demand method requires only 3 doses of drugs. I thought that it requires four? Two doses 2 to 24 hours before potential sexual encounter and then one dose 24 hours later and then another 48 hours later. Is the three dose strategy as good as four dose one?
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H. Hunter Handsfield, MD
49 months ago
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The first dose is two pills; the next two are one pill each. Four pills, 3 doses. Sorry for any confusion. In any case, do not follow these recommendations: take the drug exactly as directed by whativer doctor or clinic prescribes it for you.---